CHOICE membership

Tell us your experience with HIF health insurance fund


#1

Do you have something to say about Health Insurance Fund of Australia (HIF)? Tell us your good experiences, bad experiences or otherwise and help inform the CHOICE Community.

Read our HIF health insurance review


#2

AVOID HIF GoldVital.

When you hear of insurers being under fire for selling ‘JUNK’ insurance policies HIF is mostly likely one of these insurers. I was recently advised I needed to have a basic, minor, common surgery - i was gobsmacked to find the junk policy HIF had sold me did not even cover this basic surgery, the only person more surprised was my GP when I told her i would not get any coverage. She was shocked at how ‘terrible’ the policy was since most insurers at the most basic level provide coverage for this surgery.
Moral of the story: AVOID HIF! And unlike me - dont find yourself circa $7000 out of pocket.

It is timely that the Federal Government is reviewing the incidence of junk health insurance sellers - hopefully HIF is under close examination with their highly questionable practices and product offerings. Reforms are urgently needed in this sector, and HIF is a contributor to these massive problems.


#4

You are absolutely, right junk insurance is very bad value cover. HIF GoldVital is obviously not the only junk insurance policy on the market, others and probably more popular ones are:

  • AHM White Lite and White Lite Saver
  • HCF Accident Cover
  • Medibank Accident Cover
  • Medibank Hospital Essentials
  • NIB Basic
  • Australian Unity Basic

Just to name a few. They usually only cover a handful of procedures and don’t cover treatments in private hospital for the most common serious diseases, like cancer, stroke or heart disease, and won’t give you access to private psychiatric facilities in case of a mental illness.

Junk policies have emerged in response to the Medicare Levy Surcharge and Lifetime Health Cover, where consumers will achieve tax savings by buying hospital insurance whether or not it provides good value for their own health care, the public health system and the community more broadly.

CHOICE is calling on the federal government to end tax concessions and rebates on junk insurance policies as they offer little value to consumers. For more on junk insurance see our report.

In our health insurance comparison tool we have a junk insurance warning in red copy to make sure that if one of those policies comes up in your results you are very sure what you are buying.


#6

Hello frags27,

Thank you for your review. I understand that you’re disappointed with the outcome of your recent claiming experience.

Our GoldVital Hospital policy was created in response to significant demand from younger consumers who consider themselves fit and healthy, and just need basic private hospital insurance to ensure they’re covered in case an accident happens. Essentially, in order to pay a much lower premium, they were happy with a lower level of cover.

HIF offers five Hospital Cover options (ranging from basic to top coverage) and we’re very keen to ensure all members are fully aware of what’s covered on the policy they choose. That’s why, when you purchased GoldVital Hospital Cover online, your policy was described as follows: “GoldVital Hospital is available to singles and couples who just wish to be covered for vital medical treatment for accidental injuries. GoldVital also covers the surgical removal of wisdom teeth, tonsils, adenoids and appendix, along with minor gynaecological procedures. Plus, GoldVital is excellent value if you want to save tax by avoiding the Medicare Levy Surcharge.”

We also have a dedicated web page and factsheet for this policy (and all other policies) which both detail all the inclusions, exclusions, restrictions and other conditions relating to GoldVital Hospital Cover. For your reference, the web page link is http://www.hif.com.au/goldvital and the factsheet link is www.hif.com.au/goldvitalhospital-factsheet

In addition, all HIF members are sent a ‘Standard Information Statement’ (SIS) at least once a year. These SIS documents are a federal government requirement for all health funds, and they clearly detail what is and isn’t covered on a member’s specific policy. I’ve just checked the last SIS document we posted to you in December 2016, and for your GoldVital Hospital policy it states, “This policy only provides full benefits for joint reconstructions and investigations, removal or tonsils, adenoids, appendix and wisdom teeth in a hospital, and same day (no overnight stay) minor gynaecological procedures. It also covers hospital treatment in the event of an accident.”

As a not-for-profit health fund, our members’ health and happiness is always our number one priority. We also have one of the highest claims/benefit ratios in our industry. For example, in the 2016-17 financial year, we paid out 95 cents in claims benefits for every dollar received in member premiums (the industry average was 86 cents for that period). I’m afraid we just can’t pay benefits on a member’s medical procedure if their chosen policy doesn’t cover it.

I hope this helps to provide more clarification on our claims assessment process, but if you’d like to discuss this further please don’t hesitate to email me on social@hif.com.au

In the meantime, I hope you’ve had a speedy recovery and feel better very soon.

Kind regards,

Nikki Atack
HIF Marketing Manager